Active NPI
Shuyang Fang, MD, MPH
- Endocrinology, Diabetes & Metabolism Physician
- Park Ridge, IL
National Provider Identifier
1134582497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- MD61350592
- Practice address
- 1775 Ballard Rd
Park Ridge, IL 60068-1005 - Phone
- (847) 318-2400
- NPI assigned
- Apr 3, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 036.154615 | IL | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | MD61350592 | WA | Primary |
Addresses
Primary practice location
1775 Ballard Rd
Park Ridge, IL 60068-1005
Mailing address
9505 S Steele St
Tacoma, WA 98444-6858
Phone (253) 597-6800
Other practice location 1
9505 S Steele St
Tacoma, WA 98444-1858
Phone (253) 597-6800
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sfang310197@direct.myadvocateaurora.org | Direct | |
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
9505 S Steele St
Tacoma, WA 98444-1858
Phone (253) 597-6800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.154615 | IL | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients |
Locations
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Interoperability endpoints
- sfang4258146@ghc.direct-ci.net
- sfang310197@direct.myadvocateaurora.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1669619870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1134582497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9505 S STEELE ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984446858",
"telephone_number": "253-597-6800",
"fax_number": "253-597-6888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 BALLARD RD",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681005",
"telephone_number": "847-318-2400"
}
],
"practiceLocations": [
{
"address_1": "9505 S Steele St",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984441858",
"country_code": "US",
"telephone_number": "253-597-6800",
"fax_number": "253-597-6888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FANG",
"first_name": "SHUYANG",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-03",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "IL",
"license": "036.154615",
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "WA",
"license": "MD61350592",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sfang310197@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1775 Ballard Rd",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681005",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "9505 S Steele St",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984441858",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.